Depression of cardiac output is a mechanism of shunt reduction in the therapy of acute respiratory failure
The relationship between changes in cardiac output and intrapulmonary shunt associated with mechanical ventilation was evaluated in 20 patients with the adult respiratory distress syndrome (ARDS). The distribution of ventilation-perfusion (VA/Q) ratios and the level of intrapulmonary shunt was determined by the multiple inert gas technique. Pulmonary blood flow was distributed predominantly to either effective gas-exchanging units or shunt units. Positive end-expiratory pressure (PEEP) or high tidal volume ventilation led to decreases in shunt and cardiac output without altering the overall pattern of VA/Q distributions. Changes in shunt and cardiac output were quantitatively and qualitatively silimar and a strong correlation was found between changes in shunt and cardiac output with both PEEP and high tidal volumes (r = 0.76). Cardiac output depression associated with tese modes of ventilation appears to be a mechanism of shunt reduction in ARDS. Interpretation of improvements in gas exchange in ARDS must take into account concomitant hemodynamic changes.
Continuous positive-pressure ventilation: effects on systemic oxygen transport and tissue oxygenation
The response of patients with respiratory failure and cardiopulmonary disease to different levels of constant volume ventilation
Mechanical ventilation and fluid management in acute lung injury. Effects on gas exchange and hemodynamics
Relationship between gas exchange response to prone position and lung recruitability during acute respiratory failure
Effect of alveolar recruitment maneuver in early acute respiratory distress syndrome according to antiderecruitment strategy, etiological category of diffuse lung injury, and body position of the patient
Influence of positive end-expiratory pressure on extravascular lung water during the formation of experimental hydrostatic pulmonary oedema
Effect of inhaled nitric oxide on venous admixture depends on cardiac output in patients with acute lung injury and acute respiratory distress syndrome
Spontaneous breathing during ventilatory support improves ventilation-perfusion distributions in patients with acute respiratory distress syndrome
Compliance is nonlinear over tidal volume irrespective of positive end-expiratory pressure level in surfactant-depleted piglets
Effects of propranolol on arterial oxygenation and oxygen transport to tissues in patients with cirrhosis
Effect of tidal volume on gas exchange and oxygen transport in the adult respiratory distress syndrome
Physiologic effects of positive end-expiratory pressure in patients with chronic obstructive pulmonary disease during acute ventilatory failure and controlled mechanical ventilation
Alveolar epithelial damage. A critical difference between high pressure and oleic acid-induced low pressure pulmonary edema
Physiological predictors of survival during high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome
Use of the oxygen content-based index, Fshunt, as an indicator of pulmonary venous admixture at various inspired oxygen fractions in anesthetized sheep
Bedside selection of positive end-expiratory pressure in mild, moderate, and severe acute respiratory distress syndrome
Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. A secondary analysis of the LOVS and ExPress trials
Dependence of shunt on cardiac output in unilobar oleic acid edema. Distribution of ventilation and perfusion
Comparison of the effects of dopamine and dobutamine during continuous positive-pressure ventilation
Combined effects of NO inhalation and intravenous PGF2 alpha on pulmonary circulation and gas exchange in an ovine ARDS model
Relief of hypoxemia contributes to a reduction in cardiac index related to the use of positive end-expiratory pressure
Hemodynamic changes during whole bronchoalveolar lavage in two cases of pulmonary alveolar proteinosis
Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans
Morphometric effects of the recruitment maneuver on saline-lavaged canine lungs. A computed tomographic analysis
Effect of increasing perfluorocarbon dose on VA/Q distribution during partial liquid ventilation in acute lung injury
Hypoxic pulmonary vasoconstriction in nonventilated lung areas contributes to differences in hemodynamic and gas exchange responses to inhalation of nitric oxide
Functional residual capacity-guided alveolar recruitment strategy after endotracheal suctioning in cardiac surgery patients
Increased flow resistance and decreased flow rate in patients with acute respiratory distress syndrome: The role of autonomic nervous modulation
Counterpoint: should positive end-expiratory pressure in patients with ARDS be set based on oxygenation? No
β-Blockers to optimize peripheral oxygenation during extracorporeal membrane oxygenation: a case series
The pulmonary vascular effects of dopamine, dobutamine, and isoproterenol in unilobar pulmonary edema in dogs
Ventilation-perfusion relationships in pulmonary arterial hypertension: effect of intravenous and inhaled prostacyclin treatment
The relationship between arterial PO2 and mixed venous PO2 in response to changes in positive end-expiratory pressure in ventilated patients
Haemodynamic stability and pulmonary shunt during spontaneous breathing and mechanical ventilation in porcine lung collapse
Central hemodynamics and right ventricular function after coronary artery bypass surgery. A comparison of prostacyclin, sodium nitroprusside, and nitroglycerin for treatment of postcardiac surgical hypertension
Effects of nitroglycerin on central haemodynamics and VA/Q distribution early after coronary bypass surgery
Effects of prenalterol on central haemodynamics and VA/Q distribution early after open-heart surgery
A comparison of prostacyclin and sodium nitroprusside for the treatment of heart failure after cardiac surgery
Beta-adrenergic antagonists improve oxygen saturation in acute pulmonary edema: a case series in the prehospital setting
A numerical model of blood oxygenation during veno-venous ECMO: analysis of the interplay between blood oxygenation and its delivery parameters
Effects of acute hemorrhage on intrapulmonary shunt in a pig model of acute respiratory distress-like syndrome
A comparison of biologically variable ventilation to recruitment manoeuvres in a porcine model of acute lung injury
Compressive forces and computed tomography-derived positive end-expiratory pressure in acute respiratory distress syndrome
Pulmonary shunt is independent of decrease in cardiac output during unsupported spontaneous breathing in the pig
Lung Recruitment Assessed by Respiratory Mechanics and Computed Tomography in Patients with Acute Respiratory Distress Syndrome. What Is the Relationship?
High PEEP in acute respiratory distress syndrome: quantitative evaluation between improved arterial oxygenation and decreased oxygen delivery
The effects of positive end-expiratory pressure in alveolar recruitment during mechanical ventilation in pigs
Small dose of exogenous surfactant combined with partial liquid ventilation in experimental acute lung injury: effects on gas exchange, haemodynamics, lung mechanics, and lung pathology
Equilibration Time Required for Respiratory System Compliance and Oxygenation Response Following Changes in Positive End-Expiratory Pressure in Mechanically Ventilated Children
Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed?
Semiquantification of Systemic Venous Admixture During Venovenous Extracorporeal Oxygenation Via Bicaval Double-Lumen Cannula in Critically Ill Patients.
Potential for Lung Recruitment Estimated by the Recruitment-to-Inflation Ratio in Acute Respiratory Distress Syndrome. A Clinical Trial
Spontaneous breathing improves shunt fraction and oxygenation in comparison with controlled ventilation at a similar amount of lung collapse
Mechanical Ventilation for Acute Respiratory Distress Syndrome during Extracorporeal Life Support. Research and Practice
Changes in shunt, ventilation/perfusion mismatch, and lung aeration with PEEP in patients with ARDS: a prospective single-arm interventional study
Effects of positive end-expiratory pressure on gas exchange and expiratory flow limitation in adult respiratory distress syndrome
What links ventilator driving pressure with survival in the acute respiratory distress syndrome? A computational study
Hypothesis: Fever control, a niche for alpha-2 agonists in the setting of septic shock and severe acute respiratory distress syndrome?
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